<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004519
Report Date: 09/25/2019
Date Signed: 09/25/2019 03:55:57 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LOPEZ, OLGA E.FACILITY NUMBER:
414004519
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
09/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Olga LopezTIME COMPLETED:
04:25 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts( LPAs) Kaur and Singh conducted an annual random inspection today. The purpose of the inspection was explained to licensee. Present at the daycare are licensee and 5 children. No change in the daycare areas. Day-care areas: living room, dining room, kitchen, bathroom, upstairs bedroom and backyard. The remaining areas of the house are off-limits. The home is equipped with a fire extinguisher, a smoke detector, and a carbon monoxide. The home is clean and ventilated properly. Children toys and equipment appear to be in good condition. All kitchen and bathroom cabinets were locked. Child protective gates are barricading the stairs . There are no bodies of water. There are no poisons, detergents, cleaning products, or sharp objects accessible to daycare children.

Licensee CPR and First aid are expiring in 03/2020. Per licensee, licensee provides snacks and lunches to the children. LPA informed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/. Children files were reviewed. Information regarding 'A Child Care Provider's Guide to Safe Sleep' was provided to the licensee and is available for review on CCLD website.

>No deficiencies cited today under Title 22 Division 12 of the Ca. Code of Regulations..

>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.
Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1